在哮喘诊断中，针对呼吸科医生评估对问卷及支气管高反应性进行验证。
Validation of questionnaire and bronchial hyperresponsiveness against respiratory physician assessment in the diagnosis of asthma.
作者信息
Jenkins M A, Clarke J R, Carlin J B, Robertson C F, Hopper J L, Dalton M F, Holst D P, Choi K, Giles G G
机构信息
Department of Public Health and Community Medicine, University of Melbourne, 200 Berkeley Street, Carlton 3053, Victoria, Australia.
出版信息
Int J Epidemiol. 1996 Jun;25(3):609-16. doi: 10.1093/ije/25.3.609.
BACKGROUND
The Tasmanian Asthma survey (TAS) and the International Study of Asthma and Allergies in Childhood (ISAAC) have used questionnaires to measure the prevalence of asthma in adults and children. We have investigated the validity of these questionnaires by comparing response to questionnaire with a physician assessment of asthma status in the past 12 months.
METHODS
Ninety-three adults were given the TAS questionnaire to complete and 361 children were given the ISAAC questionnaire. Ninety-one adults and 168 children completed bronchial challenge with hypertonic saline. A consultation with a respiratory physician blinded to the results of the questionnaire and bronchial challenge was given to all subjects.
RESULTS
In both adults and children, questionnaires showed high agreement with respiratory physician diagnosis with respect to asthma symptoms in the past 12 months. For the TAS questionnaire the positive and negative predictive values (95% confidence limits) for physician diagnosis for adults were 0.89 (0.68-0.98) and 0.94 (0. 86-0.98) respectively. The instrument was also sensitive 0.80 (0. 58-0.93) and highly specific 0.97 (0.90-0.99). For the ISAAC questionnaire the positive and negative predictive vales for physician diagnosis of asthma in children were 0.61 (0.50-0.71) and 0.94 (0.88-0.98) respectively. Sensitivity and specificity were 0.85 (0.73-0.93) and 0.81 (0.76-0.86) respectively. Compared to the physician diagnosis, the sensitivity of bronchial hyperresponsiveness (BHR) for asthma was low for adults 0.39 (0.21-0. 61) and children 0.54 (0.48-0.67) as were the positive predictive values: 0.55 (0.31-0.79) for adults and 0.64 (0.449-0.77) for children. A definition of asthma requiring both a positive questionnaire response and BHR was highly specific but not sensitive for adults 0.37 (0.20-0.59) or children 0.47 (0.35-0.60).
CONCLUSIONS
Both the TAS and ISAAC questionnaires are valid instruments for the determination of asthma symptoms in the past 12 months.
背景
塔斯马尼亚哮喘调查（TAS）和国际儿童哮喘和过敏研究（ISAAC）使用问卷来测量成人和儿童哮喘的患病率。我们通过将问卷回答与医生对过去12个月哮喘状况的评估进行比较，来调查这些问卷的有效性。
方法
93名成年人被给予TAS问卷以完成，361名儿童被给予ISAAC问卷。91名成年人和168名儿童用高渗盐水进行支气管激发试验。所有受试者都接受了一位对问卷和支气管激发试验结果不知情的呼吸内科医生的会诊。
结果
在成人和儿童中，问卷在过去12个月哮喘症状方面与呼吸内科医生的诊断显示出高度一致性。对于TAS问卷，成人医生诊断的阳性和阴性预测值（95%置信区间）分别为0.89（0.68 - 0.98）和0.94（0.86 - 0.98）。该工具的敏感性为0.80（0.58 - 0.93），特异性为0.97（0.90 - 0.99）。对于ISAAC问卷，儿童哮喘医生诊断的阳性和阴性预测值分别为0.6l（0.50 - 0.71）和0.94（0.88 - 0.98）。敏感性和特异性分别为0.85（0.73 - 0.93）和0.81（0.76 - 0.86）。与医生诊断相比，成人和儿童哮喘的支气管高反应性（BHR）敏感性较低，分别为0.39（0.21 - 0.61）和0.54（0.48 - 0.67），阳性预测值也较低：成人为0.55（0.31 - 0.79），儿童为0.64（0.449 - 0.77）。需要问卷回答阳性和BHR两者的哮喘定义特异性很高，但对成人（0.37，0.20 - 0.59）或儿童（0.47，0.35 - 0.60）不敏感。
结论
TAS和ISAAC问卷都是确定过去12个月哮喘症状的有效工具。
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